Affordable Care Act Working?, Which Was Written

¶ … Affordable Care Act working?," which was written by Margot Sanger-Katz and was published in the New York Times. The article takes a look at whether the Affordable Care Act, which came into effect a year ago, has had the desired impacts. The author breaks down the objectives of the act into different categories: number of uninsured, insurance affordability, health outcomes, online exchanges, the state of the healthcare industry, expansion of Medicare and the overall level of health spending in America. The article is discussing the Affordable Care Act.

Most of the provisions of the Act have now come into place, so the article takes a look at the statistics in an attempt to gauge whether or not the Act has had the desired outcomes, or if it is making progress. The Affordable Care Act is a comprehensive package of policies that affect most aspects of the health care system, especially with respect to insurance and patient care.

The article itself is also aimed at taking a look at the different aspects of the ACA, in order to determine whether or not it has been successful. So most of the outcomes are analyzed from the perspective of the customer -- certainly it is the customer/patient/end user who cares most about having insurance, the cost of insurance, their health outcomes, the and the status of the online exchanges.

The other components of the article are either industry-centric (health of the industry, expansion of Medicare) or government-centric (overall level of healthcare costs in America). So there are a few different stakeholders discussed, but the audience for the New York Times is consumers, not politicians or the industry, though they may read it as well. Ultimately, the interest of the consumer is the most important facet of the article.

The article seeks to outline the performance, so basically measuring the policy with respect to its ability to deliver on the expected benefits. For example, the ACA was supposed to, in a few different ways, contribute to better bargaining power on the part of payers, which would theoretically lower the total cost of the health care system.

The author identifies that the trend in health care costs has been going downward -- at least the growth rate has slowed, so that one year of the ACA cannot be credited with the decline in the growth rate last year either. That said, it is still expected that the ACA will contribute to a long-run decrease in healthcare costs, just that one year is not enough to see the effects of that policy.

For employers, the ACA was expected to increase complexity during the implementation phase, as any major new law would do. There is nothing in this article that discusses the issue directly, but there has not been much talk of there being major implementation issues, in particular as the ACA mostly affects the payer side. That said, it is expected that there may be a shortage of capacity in the industry, as the number of uninsured decreases, thereby increasing demand for healthcare that current providers are unable to absorb.

The ACA was ultimately targeted at consumers. Certainly, health insurance is more widely available than it was before. The article points out that the number of uninsured Americans has declined 25% over last year. This is probably not as far as the Obama Administration had anticipated, but the number should continue to drop, especially when enforcement of penalties for not enrolling begins. But consumers were concerned about the cost of health care.

One outcome is that the ACA has levels of plans, and some consumes find even the bronze level is more than the insurance that they had before. The results here are mixed. For some people, like the ones just described, premiums are likely to go up, while for others the availability of subsidies has reduced the cost of health care. It remains to be seen what the long-run outcomes of insurance costs will be.

For the insurers, the ACA has been a boon, providing them with millions of new customers, and forcing other customers to upgrade their plans. The insurance companies were expected to be big winners of the ACA, and that has come to pass. They are presently doing battle with Congressional Republicans over the latter group's desire to repeal the ACA. Provider organizations were concerned about the capacity.